1. Does Culture Affect Brain Function? n Questions and Answers from Clinical Neuropsychology n Antonio E. Puente n University of North Carolina at Wilmington n University of Oklahoma School of Medicine n December 7, 2002

2. Outline n Purpose of Presentation n Background and Biases n Assumptions and Limitations n Defining Concepts n Examples from Four Neuropsychological Studies n Pragmatic Observations n Theoretical Speculations

3. Purpose of Presentation n Summary of 25 Years of Research Where Do Biopsychosocial Variables Fit in Brain Dysfunction? n Searching for a Neuropsychological “g”

4. Background and Biases n Not About Correctness; It’s About Science n Ethnicity n Educational n Professional n Theoretical –Sperry –Vygotsky-Luria

5. Assumptions and Limitations n Philosophy Vs Science n Functional Vs Organic n Culture Vs Biology n Individual Vs Contextual

6. Defining Concepts n Culture (Shared Extra-genetic Knowledge) n Brain and Neuropsychology (Processor of Information; Information about the Processor) n Intelligence and Cognition (Understanding/Tracking/Using Discrete Information)

7. Examples from Four Neuropsychological Studies n Background –Grenada, W.I.- Hypertension & Stress –Argentina- Fulbright & the Malvinas –Puerto Rico- APA Visiting Psychologist Program & the Translation of Test

8. Examples from Studies: Continued n Intention –Why do Ethnic-Minorities do Poorly on Most Cognitive & Neuropsychological Measures? –Three Generations = Anglo Saxon –Cattell and the Concept of “g” –Is There Common Information Processing Across Cultures?

9. Examples From Studies: Four Attempts n Wechsler Intelligence Scales n Luria-Nebraska Battery n Amazon Indians n Russia

10. Wechsler Scales: I n Background –Item Bias on the Wechsler Scales –WISC n Puerto Rican Version n WAIS vs WISC

11. Wechsler Scales: II n Principal Collaborators In Psych Corp: –William Hrabrick,, Aurelio Prifitera, Michael O’Callahan, David Tulsky n Principal Co-Collaborators: –Alfredo Ardila, Josette Harris, Andres Barona, Laura Herrans (& Monica Rosselli) –Consulting Workgroup (7) n Other Collaborators: –50-70 School and Clinical Neuropsychologists Throughout the US

12. Wechsler Scales: III n Time-Frame n Items n Production n Sampling n Standardization

13. Wechsler Scales: IV n Time-Frame: –Initial Work= late 1980s-1993 –Formal Work= 1994-2001

14. Wechsler Scales: V n Items: –Borrowed Items –Explicit and Implicit Bias –Across Hispanic Subgroup Agreement –Scoring Criteria

15. Wechsler Scales: VI n Production: –Using Prior WISC & Foreign Versions –Drawings –Printing –Pricing & Packaging –Production

16. Wechsler Scales: VII n Sampling: –Age –Sex –Educational Level (child and parent) –Country of Origin –Acculturation Level –Language Preference of Child –Socio-economic Status

17. Wechsler Scales: VIII n Standardization: –Examiners n 36 n Geographical & Cultural Variability n Taped Tryout –Methods n Tryout= 600 n Standardization= 1,000 n Test-Retest= 300

18. Wechsler Scales: IX n Current Status: –“On Hold” –No Internal or External Project Director nor Funding

19. Luria-Nebraska Neuropsychological Battery: I n Background –National Academy of Neuropsychology 1979 Meeting in Orlando –Luria-North Dakota Neuropsychological Battery –Initial Collaboration with Golden & “Item Interpretation of the Luria-Nebraska Neuropsychological Battery” –Chilean Journal of Psychology (1982)

20. LNNB: II n Failed Attempts: –Argentina –Puerto Rico n Spanish Collaborators: –Madrid- Juan Tobal, Antonio Cano, Juan Manuel Cepedez, Itziar Iruarrizaga –Granada- Juan Gody, Juana Garcia. Miguel Perez –Other- Salamanca; TEA, Western Psych.

21. LNNB: III n Literature Review: –500 Total Articles on the LNNB –34 on the LNNB and Ethnic/Foreign Samples –4= Children; 30= Adult –Empirical= 23 (BD, Schizophrenia) –Translations= 9

22. LNNB: IV n Problems: –Items n Hispanic Subculture n Literal Translation –Copyright n Luria n Christensen n TEA n Western Psychological Services

23. LNNB: V n Translation: –Original Translation by Bilingual Neuropsychologist –Back Translation by Two Bilingual Neuropsychologist –New Translation Developed –Discrepancies With English Translation Reconciled

24. LNNB: VI n Major Item Changes: –Receptive Speech –Expressive Speech –Writing & Reading –Arithmetic –Intellectual Processes

25. LNNB: VII n Sampling: –Total= 232 (men= 126; women= 106) –Mean Age= 39.88 (15-88) –Mean Education= 9.93(0-21)

26. LNNB: VIII n Correlations with LNNB I: –Range=.5356 to.7232 –Education= -.48 to -.72 –Scales=.52 to.845

27. LNNB: IX n Next Steps: –Publishing Patient Group Info –TEA/Western Psychological Corporation Copyright & Related Difficulties

28. Amazon Indians: I n Background: –Culture-free Sample –Caribbean, Latin America, Spain, Russia n Collaborators: –Vivian Andrade (Brazil) –Miguel Perez (Spain)

29. Amazon: II First Study n Task –CVLT Type Task (15 words) –Words in Guaranis & Portuguese n Sampling –Total= 20 –Guaranis (educated vs “uneducated”)

30. Amazon: III (First Study Continued) n Results: – Verbal Memory n similar number of words in first trial n different learning curves n more words total for indigenous Indians

31. Amazon Indians: IV Second Study n Sample –N= 12 per group –Educated vs “non-educated” Guaranis n Tasks –CVLT type task (15 matched words) –12 Figures of indigenous animals –WMS-R Logical Memory –WAIS-R Digit Span –WAIS-R Block Design

32. Amazon Indians: V Second Study (continued) n Results –No between-group differences –“Un-educated” Indians did significantly better in motor and visual tasks than in verbal tasks in either language

33. Russia n Background –Luria & Vygotsky –Biannual International Luria Conference –Anna Agranovich

34. Russia: II n Sample Total = 40 per group USARussia Age28.95 (18-44)29.15 (18-43) Ed.13.68 (12-17)14.25 (12-17)

35. Russia: III n Methodology/Instruments Hemisphere Anterior Posterior left/verbalFluencyDigits Forward Digits BackwardVerbal Memory right/visualRuff Figural FluencyVisual Memory Color TrailsClock Test

36. Russia: IV n Results TestUSARussia –Verbal Fluency21.7524.18 –Digits Backwards 7.83 6.75 –Digits Forward10.58 9.70 –Verbal Memory41.6543.50 –Visual Memory23.05 22.63 –Clock 8.55 8.83 –RFFT 114.80 103.40 –CTT126.08 38.30 –CTT261.63 75.46

37. Some Pragmatic Observations n Translations –Typical vs Required n Translators –Typical vs Required n Norms –Paucity of Data –Heterogeneity of Groups n Criterion Validity –Who is the Reference Value –What is “Brain Damage” n Personnel –Few Academics, in general –Even Fewer Ethnic-Minorities Within the Field

38. Some Theoretical Questions n New, Novel, & Extremely Difficult n History and Culture Do Matter n Personal Manipulation of History and Culture Matter Even More n Cultural Knowledge Might be the Manner in Which Natural Selection Expresses Itself in Homo Sapiens n Clinical Neuropsychology Might Help Unravel This Expression

39. Answers with Questions: Where Do We Go From Here? n Is Reductionism Enough? n Is the Tabula Rasa Really Blank? n Does Individual Cognition Affect Gene Pool Constitution? n If so, is Culture the Mechanism? n Is Intelligence and Neuropsychological Constructs (e.g. Memory, Problem Solving, etc.) Equal to Understanding of Culture? n If so, Does Mind Emerge from Brain and, in turn, Control Brain?

40. Further Information n Address: –Department of Psychology, UNC-W, Wilmington, NC 28403-3297 n E-mail: –puente@uncw.edu n Web Site: –clinicalneuropsychology.us –uncw.edu/people/puente